The role of patients' meta-preferences in the design and evaluation of decision support systems


Dowie, J; (2002) The role of patients' meta-preferences in the design and evaluation of decision support systems. Health expectations, 5 (1). pp. 16-27. ISSN 1369-6513 DOI: https://doi.org/10.1046/j.1369-6513.2002.00160.x

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Abstract

The arrival of new analysis-based decision technologies will necessitate a profound rethinking both of the nature of the patient-doctor relationship and of the way aids and support systems designed to improve decision-making within that relationship are designed and evaluated. One-dimensional typologies of the traditional 'paternalist/shared/informed' sort do not provide the complexity called for by the heterogeneity of patient's 'meta-preferences' regarding their relationship with a doctor on the one hand and regarding the analytical level of judgement and decision-making on the other. A multidimensional matrix embodying this distinction is proposed as a framework of the minimal complexity required for the design and evaluation of the full range of decision aids and decision modes. Essentially aids should be conceived of and evaluated cell-specifically and the search for universally satisfactory decision support systems abandoned. 'shared' and'informed' are best interpreted as attributes which may or not be in line with a patient's meta-preferences. Future research should focus on the higher level goal of better decision-making, a goal that will need to respect and reflect these meta-preferences.

Item Type: Article
Keywords: Counseling, Decision Making, Decision Support Systems, Clinical/*standards, Great Britain, Human, Models, Organizational, *Patient Participation, *Patient Satisfaction, *Physician-Patient Relations, Software Design, Counseling, Decision Making, Decision Support Systems, Clinical, standards, Great Britain, Human, Models, Organizational, Patient Participation, Patient Satisfaction, Physician-Patient Relations, Software Design
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
PubMed ID: 11915844
URI: http://researchonline.lshtm.ac.uk/id/eprint/17653

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